Substance Abuse and Free Will

All drugs, whether legal or illegal, impact our brains.
When trying to medically define the disease of substance abuse, describing addiction as a chronic brain disease, although true, does not fully explain this disease to a lay person.

How does one explain a disease that causes devastating changes in behavior of one who is addicted, such that even the most severe threat of punishment is insufficient to keep them from taking drugs.  Or to describe an addiction that makes the addict willing to give up everything they care for, in order to take a drug.  So, to state that an individual is suffering from chronic brain disease is referring to something specific and profound.  Our definition of brain disease defines  that an addict’s brain is no longer able to produce something needed for their functioning and that healthy people take for granted – free will.

All drugs, whether legal or illegal, impact our brains.  They cause large surges of dopamine in the brain areas crucial for motivating our behavior.  They can affect both the reward regions (such as the nucleus accumbens) as well as the prefrontal regions that control our higher functions, like judgment, decision-making and self-control over our actions.  Brain circuits will begin to adapt to these drug-induced surges and become much less sensitive to their brain’s natural supply of dopamine.  The result is that ordinary healthy experiences in our lives – those pleasurable social and physical behaviors necessary for our survival (which are rewarded in a healthy person by small bursts of dopamine throughout the day) no longer are enough to motivate the addicted person.  The addicted brain now needs the big surge of dopamine that comes from their drug just to feel temporarily okay; and they find they must continually repeat this, in an endless cycle.

Many addicts try to quit on their own.  However, they may find that they are unable to control the chemical needs of their brains and resort to more consumption of their drug of choice.  Family and loved ones may suffer from the stigma of shame associated with the behavior of the addict, not fully understanding just how “out of control” they really are.  They fail to realize that the addict’s diseased brain circuits that would have normally enabled them to exert free will, no longer function as they should.  It is no longer a matter of free choice; because they no longer can choose.  Many times addicts have actually shared that although they no longer even experience pleasure from the drugs; the distress of not taking the drug is too difficult to bear.

Once family, friends and loved ones understand the underlying pathology of addiction, they can begin to appreciate the need for providing their addict with the professional help they need.  Like a child with diabetes or a person with heart disease or cancer, they are provided with the professional medical, emotional and behavioral treatment and care necessary to eliminate the physical addiction to drugs and to help the recovering addict begin to rebuild a life of health through sobriety.

Distributed by Client Initiatives

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